Need help adjusting 14 month old's day - Lots of NW's

[essexlemon]

OK.  so we started sleep training a while ago and got down to one NW with DS2 waking just once in the night around 3am (if I fed him he would go back down but if I tried the cross between PD and GW that I was doing at BT it turned into an EW).  We had him going down independently at naptime and bedtime but only if I stuck very very closely to our routine.

We moved DS1 (who has NW and NT issues of his own) back into the room when my parents came to stay, so that our bed was free to use as we needed the campbed DH and I had been sleeping on for the past month.  It went ok for the first couple of nights but with an extra NW, then went completely pear shaped.  Then DS2 broke out in chicken pox.

He's a reflux baby so has never got into the habit of putting himself to sleep.  He would try valiantly as a tiny baby but just as he was going off the pain would wake him.  A sleep 'specialist' from the HV team came out to help show me how to settle him (she was pretty much advising that I CIO but with my hand on his chest which I wasn't comfortable with) but when she saw how he was trying to settle she advised that I see the GP and worry about sleep when he was older and less gassy.

He kind of settled back into a feed-to-sleep routine after the pox but we were left with an hourly wake up through the night (and with it taking me 20-45 mins for me to resettle neither of us were getting much sleep).  I tried transfering him back into our bed but he was still up for most of the night.  We are wheat and dairy free at the moment to see if it helps but it doesn't seem to have done.  He would generally crash out in our bed after an hour's walkathon at around 3am (feed to sleep wouldn't help at all here) and be up at 4-4.30am for the day (his longest stretch of sleep of the night).  We recently saw a local town's Christmas light celebration (we were there by accident - I had an optician appointment) and so we were late home for BT.  DH kept them up until 7 when we got home (we are usually a super early bedtime - or stupid early bedtime as it's become known in our house - a source for many many arguments between DH and me - we were doing 5pm for DS1 due to night terrors and then laying DS2 down between 5.30 and 6pm as he would go balistic once DS1 was in bed and I felt it was a long stretch awake for him from his nap).  DS1 slept all night and woke up around an hour later than normal (shortlived though, he now wakes less than half hour later so is losing over and hour and a half sleep - DH is adament that this will improve though despite NT's starting up again) DS2 slept until 12.30 so a whole five hours, then woke at 3.30 and again at 4 but then slept till 6am.

The trouble is that although he is sleeping better at night, he is seriously OT long before bedtime.  He won't tolerate any noise in the room (we tried putting DS1 down after him last night and he went back to his pattern of hourly NW's) so he really needs to go down after DS1.  It's also going to be really difficult doing any sleep training because DS1 has NT's if he hears DS2 crying while he is asleep and I really don't feel like sleeping on the camp bed for another month while we try to sort things out, especially as we failed spectacularly last time.

He is currently up around 5.30 - 6am and has booby feed.

Down for a nap at 10 - 10.30ish.  Awake between 11 and 11.55 (I have to wake him up at about 11.55 to go and collect DS1 from preschool) - he tends to sleep longer with a 10.30 naptime.

Home with DS1 and main meal around 12.30 - 12.45

I was trying to get a nap in the afternoon around 2pm but he refuses this and won't even drop off in the car.  It was also getting difficult to try to keep DS1 occupied while I was getting him down.  We also have a lot of playdates in the afternoons (DS1 is a 'handful' to put things very mildly so we need to get out).  On the odd occasion when he did drop off I'd park somewhere and try to get half hour out of him but he tended to be up for most of the night on those days so I gave up the nap and just started putting him down shortly after DS1 at 5.30ish.

DH is really adament that he wants a 7pm bedtime for the boys and an earlier bedtime seems to lead to a very early start (for DS2 at least - I still believe that it improves things for DS1) but I can see him gradually getting more and more OT as the days go by.

Any ideas as to how to fix his naps?  DS2 dropped the afternoon nap early and did better with a monster 3-4 hour nap at around 11am but of course that's not an option this time as we have the preschool run (I don't have any family nearby who can sit in or pick up DS1 and I wouldn't trust my neighbours to do it - nice enough people at arm's length iykwim).  I'm toying with the idea of a morning catnap but I know from experience that getting him down for 9.30 is a struggle and there will be lots of APOP to get him off in the afternoon/lunchtime because of DS1 being about.  Lunchtime is also a time when DS1 tends to turn into a psychopath so very difficult to do naps then.  Is it possible to do a catnap as late as 3 or 4pm at this age if we keep our morning nap?

Apologies for the length of this.  I'm up against the clock to get a post done so no time to really order things in my head.  I hope at least a bit of this makes some sense!

[Smurfette]

Ok, so DS1 is 3.5 years old ish? With an average bedtime of what?
When did he drop his afternoon nap? (When you say he becomes a psychopath in the afternoons screams to me that he is tired and still needs a nap or some down time) You may also need to introduce sleep rules/rewards/consequences too.
Does DS1 have night terrors or night mares? Can you explain what happens, how long they last and how frequently in a week they occur?
Is he an independent sleeper?

DS2-when you say he dropped his afternoon nap early-how early is that? Most children on average drop it between 15-18 months so this may be the route of your troubles here.
I think his lack of self soothing skills is also part of the trouble, but I would work on routine first for a few weeks and then tackle sleep training next month.
Can you go back to 2 naps?
If so this is what I would do
wake up 5:30-6 ish
1st nap-asleep between 8:30 and 9 am-depending on how early he woke in the morning
2nd nap-between 12:30/1pm again depending on previous nap and length
bedtime 3.5-4 hours after wake up from last nap.

There are biological sleep windows that exsist that make it better/easier for kids to sleep in so these times kinda stay consistent if you want the most restorative sleep. Now seeing as he's close to really only needing one nap, he may follow this routine for a few weeks and then start to resist one of those naps so then you would need to reasses at that point. But it sounds like he's quite ot at this point.

If going back to 2 naps is not an option then you want his one nap to start somewhere between 12-1pm (no later than 1pm though) and then bedtime needs to be flexible based on the quality and duration of that nap but again somewhere around 3.5-4 hours after he wakes up. But of course go earlier if he needs it.

There is nothing wrong with early bedtimes and I think you are on the right track with them. If your children are showing signs that they are tired or even overtired, then why wouldn't we put them down when they need it?

[essexlemon]

Sorry for the delay replying - the phone and computer are triggers for bad behaviour with DS1 and both boys have been up through the evenings with a nasty cough so no time to get online until now.

DS1 is 3.5ish. 4 in February. He was having a 2hr nap up until about six months ago when it just wasn't fitting in around preschool. We were having a lot of behaviour issues back then too which looked like OT to me despite him getting at least 2hrs nap a day plus 11 to 12 hours sleep a night (his sleep has always been a bit complicated mind you). With preschool starting the nap worked out too late for him to get a decent sleep in and he was waking up miserable. DH was pushing to drop the nap and it was a source of real tension which I didn't think wad helping his behaviour. We were on a 6 - 6.15ish bedtime back then - he is an early waker who woke even earlier with a later bedtime. We started having NT's so pulled BT back to 5pm on advice from Skatty. It stopped the NT's but DH has never been happy with moving further away from a later BT (his dream is to see DS after work and get up later in the morning). Previously if we have tried to nudge him round by even just 5 or 10 minutes the NT's have started up again.

With the NT's he *wakes* screaming and will look straight at us but with hid eyes glazed and very dilated. Sometimes he will wake and want comfort sometimes bit. We found that if we just observed and let him go back ti sleep he was waking with one every hour so DH lifts him and takes him into our room (in an effort not to disturb DS2) rouses him just a bit (he calms quickly with the milder ones but with the bigger ones he could be a while. Generally if he can wake him he will be calm and go back to sleep with a bottle). When we were trying to just watch and use soothing phrases he would repeat them over and over until around 4am when he would wake and refuse to sleep again. They are fairly unpredictable and we were getting them in patches. They usually start anything between an hour to five hous of putting him to bed although he has had them as late as 3am (wasn't a nightmare - he didn't recognise DH or me and kept screaming for Daddy with the glassy stare. They are often triggered by the sound of DS2 crying. With the recent BT change he didn't have them to begin with then they started again with the beginnings of a cold (we always have more when he is ill). I gave him a homeopathic remedy a couple of nights ago and they stopped again (but bog standard wake ups continued).

He is a semi independent sleeper. When DH does BT he has to stay in the room but when I do BT we do milk during a story, then a couple of short BT books (always the same ones) after milk is finished. Kiss goodnight. Short protest some nights but usually not (asks me to stay but I say I need to get W ready for bed) close door. Silence. He is always asleep very quickly if no one stays in the room. Once asleep though he won't settle on a NW without falling asleep on a bottle. We have very heavy wetting in the night but this was already an issue before DH started giving him milk in the night (I used to end up with long periods where I would need to WIWO through the night then he'd sleep for a few weeks then back to WIWO again.

We've seen an ENT on a hunch (my parents stumped up for us to go privately as the GP wasn't interested) as he used to have a lot of ear infections. He confirmed that there was a high level of fluid/pressure in one ear but insisted that that's quite normal at this age. Tonsils and ad anodises aren't large enough to cause an agesobstruction/apnea. My feeling is that his ears are probably largely to blame for the sleep and behaviour.

DS2:
Dropped the afternoon nap at just a year! Very resistant to it even in the car.

A 9am nap isn't possible unfortunately as we have the preschool run. Sometimes he will start dropping off on the way home (15 min drive each way) but if I keep him awake so I can lay him in the cot the earliest he will sleep is about 10. He won't transfer from car to cot if he drops off. Should I let him fall asleep in the car and just keep driving to get a 20 min catnap out of him (if he drops off in the car it'll usually be about 9.30ish) and then do the main nap at 1? (12.30 won't be possible because of our pickup times). How long should that later nap be? (The last couple of days he has been going down at 10.15 and I've had to wake him for the preschool run just before 12).

I managed to get a lunchtime nap earlier in the week when we have a day at a preschool that is slightly closer (we split our hours between two schools). He was up all morning then down at 12.45 but hard work to get off (bribes aplenty to keep DS1 quiet) up at 1.30 . Needless to say he was a mess by 4pm so I hurried tea time along and got him to bed for 5 but we had a lot of wake ups. He has come out with a horrendous cough so that could be making him extra OT but... I think you are right that we need two naps at the moment but I'm struggling to find a spot that fits his clock and does nt clash with drop off or pickup. DS1 always had a stronger morning nap and W has always leaned the same way - don't know if that helps fathom him out a bit.

We finally had a visit from a specialist HV for DS1's behaviour and they have said they will work on his sleep and getting rid of bottles which should help but I am super scared of the resistance we are going to get, especially with DS2 being such a light sleeper!

Thanks so much for your help with this. Sorry for all the rambling.

I think my main question at this point is whether it is ok to make the am nap slightly later to fit in with preschool and do it as an APOP car nap and how long does it need to be?

[Smurfette]

With DS1-I think you might need to keep bedtime at 5 for the time being. If he was sleeping 11-12 hours a night, plus a 2 hour nap, plus a bedtime of 6 15 before, then he obviously loves his sleep and you (hubby,really) need to respect that. It's in the best interest of your whole family. It won't be forever, but it will be for awhile. DH will just have to make the time really count when he is home with DS1.

Also, sometimes NTs are linked to being too warm (as well as OT), but it sounds like your little guy really, really likes his sleep so I'm guessing that is where it's coming from. Can you offer him a nap on weekends to help him catch up?

DS2- Yes, if you can do 2 naps, then try that. One at 10am (or sooner if you can) and then another at 1.It might need to be a bit later if he takes a long morning nap, but deal with that as it comes. So it might be a 10-12 nap and then a 2pm-? nap for right now. But later if you need to cap that morning one at an hour (10-11am) then you can start to bring that pm nap up a bit earlier closer to 1.
 I wouldn't make a habit of only doing a 20 min nap in the car only because sleep in motion is not as restorative as lying flat and non moving. I also wouldn't cap anything yet until you can start to see some patterns establish.

Once he is caught up and the NWs stop ( I'm assuming that they are all OT related and not prop related though), then you can try going back to one nap if you find he is resisting one nap consistently for over a week straight.

HTHs

[essexlemon]

Thanks Smurfette.

DS1 has miraculously started sleeping through till 6-7am so he is on about the same nightsleep as he was on the 5pm BT.  Since it was such a source of bad feeling between DH and me I think we will leave it there for now, especially as he hasn't had a NT since I gave him some Stram (homeopathic potency).  The specialist HV (for his behaviour - we finally got our appointment after lots of other health professionals fudging and making like the service didn't exist  ) is going to look at sleep as part of their care package (along with lots of communication games and visual cues for when he can't listen).  They aim to get rid of the milk at BT (DH is not happy about this - he doesn't see the milk as a problem as he doesn't disturb us if there are bottles in the bed but I don't think it's helpful that he *needs* the milk to stay asleep.

With DS2, I'll redouble my efforts at getting a pm nap out of him and see how we get on with it.  We have some appointments coming up at the beginning of this week that are going to put a spanner in the works but I don't have a choice on those so we will have to fudge round them for now.  He also has a nasty cough and cold that is really affecting his sleep patterns (morning nap is down to less than an hour with him desperately trying to go back to sleep for half hour or so and then screaming blue murder - he was trying to settle on his own with me crouched in a corner so he wouldn't see me as I figured it was best not to step in while he was trying to self soothe) - he's back in my bed as of last night as it was the only way to get a few minutes sleep for myself.  He didn't really sleep any better for having me there, I was just shattered from keep getting out of bed every half hour and worried about disturbing DS1 with the constant toing and froing in the bedroom.  I have been trying to get him to bed early as he has been even more resistant to the pm nap since the cough came out but it's been a washout and he's been going off later than ever (finally crashed at 8.30 last night after attempted feed to sleep, walk to sleep, drive to sleep, Daddy carry to sleep etc - exhaustion finally kicked in).

All in all, I think it will be a while before I start to see a natural sleep pattern emerging for him - going on his sleep just before the cough hit it looks like he was trying to go to a monster nap like his brother (I was having to wake him from DEEP sleep at 12, after a two hour nap, to collect DS1).

I'll update as soon as we can start getting something like the routine you've suggested to save you going through masses of me rambling about illness driven OT.  He grinned his way through an attempted set down at 9.30 so I'm going to try again in a mo to see if we can get something out of him this morning.

Thanks so much S.  I really appreciate you taking time out to help, especially with the new baby and everything.  I know I can get him sorted with your help. 

[Smurfette]

if there are bottles in the bed

Do you mean that they are left there in the crib for him? That's actually not recommended as it's not good for their teeth. (Plus it creates a sleep prop that will eventually have to be weaned).

(finally crashed at 8.30 last night after attempted feed to sleep, walk to sleep, drive to sleep, Daddy carry to sleep etc - exhaustion finally kicked in).

Just spend all the effort trying to get him to sleep in his own bed. Don't start adding other means to try to get him to sleep. The more consistent you are and the sooner you start it, the sooner it will start to take effect. It will take hours the first few times but that's normal and expected. Don't start the process of winding him down in his room and then take him for a car ride, etc. You will only confuse him as to what's expected.

Hang in there!

[essexlemon]

Thanks S.

We don't do wind-down in his room because DS1 is such a nightmare sleeper and they share (haven't another room to use and DH disturbs him if we have him in our room).  I used to feed him downstairs in the lounge with low lights, burp (more as an excuse to sit him up and jiggle him properly awake than anything) then head upstairs with dim lights and tell him a short story on the way then he'd go happily off to sleep as long as I stood by the cot but that all went to pot a couple of months ago and we ended up feeding to sleep every night - he finally came out in chicken pox which explained the deterioration but we never managed to get back to him going off by himself.  Even then he used to wake a couple of times a night though.  Now I feed him in our room then lay him down asleep - that'll have to change, obviously, but while we're sorting out his timings and trying to shake this rotten cold (poor thing can't feed properly and keeps 'pahh' ing where his nose is so blocked and drippy) I'm just doing anything I can to get him off.

Would you be inclined to start sleep training as soon as he is less congested or wait for some patterns to emerge?  Do you have any tips for sleep training two at once - the HV team will be working with us over the next few weeks on DS1 so night times are going to be pretty hard going for a few weeks (please make it weeks and not months :O )

We went to see the ENT as he (DS1) had some pressure in his ears a few months ago (which I had suspected for well over a year but been unable to get anyone to check it) and we went for a follow up today.  The pressure was still up (and worse than before in one ear) but they don't want to do anything because it isn't affecting his hearing.  I'm convinced though that it has a lot to do with our sleep and behaviour issues but they are adament that as his hearing is fine it is a non-issue.

Oh, DS2 refused to sleep at 9.30 this morning so I gave up around 10.15 and took him to playgroup.  We had lunch when we got back and then I managed to bribe DS1 to stay quiet while I put him down for a nap at 1pm - he woke up after just 20 mins snuffling and coughing and DS1 burst into the room while I was trying to resettle but by some miracle he went back down again and slept until 2.30.  By the time we got back from the hospital today we got him down for 7.30 which wasn't ideal but he went down sort of semi-awake and dozed off.  We've had one wake up but he resettled after I held him upright for a bit - he was very congested.  I don't suppose we'll have a good night with him so bunged up but you never know...  He's never done a decend lunchtime nap before.

[Smurfette]

Would you be inclined to start sleep training as soon as he is less congested or wait for some patterns to emerge?  Do you have any tips for sleep training two at once - the HV team will be working with us over the next few weeks on DS1 so night times are going to be pretty hard going for a few weeks (please make it weeks and not months :O )

I would wait until he's well, for sure, but whether to wait until you see some patterns-it's hard to say.

For sleep training 2 at once- I personally wouldn't. I would probably start with the easier one first. But I'm not sure which one that is right now. With the older one you will probably need to start with a rules/rewards chart and that sometimes takes a lot of consistency to keep reinforcing. But with the younger one it's hard to sleep train when you don't know when/where they are in their sleep needs. So perhaps you might want to just start with the younger one and just at bedtime for right now so that you can all start getting solid nights sleep on a regular basis.

Can you start at least recording/logging their sleep patterns right now so you can at least look back in a weeks time and see very clearly what's been happening?

[essexlemon]

Thanks S.  I'll try to make more of an effort to actually write things down as they happen sleepwise.  It's hard because with so many wake ups recently I stopped looking at the clock so often I don't really recall how many wake ups, what time etc but i will start making a note again.

DS1 seems to be going down with the same as DS2 so I think I will start decent sleep logs and come back when they are over the worst.

[Smurfette]

Ok, sounds good.